The goal of this study is to enhance our ability to assess and examine the varied and unique ways in which cancer impacts quality of life (QOL) for young adult survivors of childhood cancer within the context of human growth and development. Preliminary work in this field suggests that the age at which cancer is diagnosed may influence long-term survivorship and quality of life. In the initial phase of this study, we will build upon a candidate measure for assessing quality of life specific to long-term cancer survivors (five years or more beyond diagnosis) and adapt it for use in a target population of young adult survivors. Interview and focus group participants will provide data on QOL and developmental issues not assessed in the current version of the instrument and not captured by existing quality of life measures. A resulting module specific to this population then will be pilot tested and ultimately administered to a sample of 400-600 young adult survivors recruited from several pediatric hematology/oncology programs. The specific aims of this study are 1) to complete the development of a candidate measure that assesses the impact of cancer across varied dimensions of QOL in long-term survivors, and to test the validity and reliability of this instrument in a group of young adult survivors of childhood cancer, and 2) to determine the differential impact of cancer in young adults as a function of the age/life stage at which cancer is diagnosed (early childhood, later childhood, adolescence). This knowledge can serve as a foundation for deriving testable hypotheses regarding the myriad variables that may influence the quality of survivors' lives throughout the remainder of their lives. The proposed project represents an opportunity for the applicant to develop advanced skills in instrument development, survey design, statistical analysis, and psychometric testing as he will be involved in all aspects of large scale survey design and administration, data collection and organization, and statistical analysis. This experience will enhance the applicant's ability to derive hypotheses and research questions from both qualitative and quantitative data. Together with a targeted program of advanced didactic instruction, this project will prepare the applicant to become a fully independent scientist in the field of cancer prevention and control research with a particular emphasis on survivorship and quality of life.